Most research in multiple sclerosis (MS) has focused on the impact of the disease on the lower extremities. To balance this, researchers at Mount Sinai Rehabilitation Hospital in Connecticut thoroughly characterized upper arm and hand functions in MS patients, finding that disease duration and disability level differently affected various measures — knowledge that might help to build better rehabilitation interventions.

Presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting June 1-4 in National Harbor, Maryland, the study was one of many excellent contributions to a session titled “Rehabilitation Interventions.” The CMSC meeting is a highlight for researchers and clinicians in the MS field, who gather to discuss new approaches and findings.

All patients in the cohort were subjected to extensive testing, including investigation of the active range of motion of shoulders, elbows, forearms, wrists, and index fingers. Isometric arm strength (raising and lowering the arms), grip strength, grip endurance, coordination, tremor, vibration sensation, and tactile sensation were also measured. Most tests were performed on both the dominant and nondominant side. Disability level was measured using the Expanded Disability Status Scale (EDSS).

Researchers noted that measures of active range of motion, strength, coordination, vibration and tactile sensation were associated with age, while gender was the only predictor of strength.

The active range of motion of the shoulders, as well as grip strength, coordination, and tactile sensation on both sides of the body were found to be associated with the level of disability. Disease duration, on the other hand, was linked to grip strength, coordination, lowering of the arm, and wrist flexion on both sides.

Several measures of the active range of motion from the dominant side also correlated with disease duration, while for the nondominant side, only wrist extension was tied to the duration of illness.

The research team also noted that associations between various measures and disease duration or EDSS score tended to differ between the dominant and nondominant sides.

In conclusion, the team believes that a better understanding of the upper arm and hand function parameters in MS patients who have different disability levels may help in the development of more adequate rehabilitation programs.

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